DESCRIPTION: Core D provides much of the clinical interface with the scientific projects. It manages patient identification and enrollment, oversees clinical management of patients, assures accurate accrual of patient information, and obtains physiologic and laboratory data as well as autopsy material. It also plays a role as liaison between the investigators at MCV and the practicing physicians in the community hospitals. 1. Significance. Core D plays a key role in integrating clinical management of extremely ill patients with data acquisition for research in projects 1-4. As such it is critical for the success of each project and the entire proposal. The personnel is comprised of four physicians and a nurse coordinator. They are in charge of overseeing patient recruitment, clinical treatment, and data collection in the form of physiologic studies and tissue specimens. They provide 24 hr/day, 7 day/week availability in order to accomplish this. They are also involved in providing feedback to all health care professionals involved in the project to assure some degree of consistency between the participating centers. The authors have devised clear outlines and protocols for recruiting patients into the study, for analyzing EEG and clinical data, and for obtaining appropriate blood and tissue specimens.